Kidney disease can quietly damage the body for years before a person realizes anything is wrong.
International researchers are now calling for much greater use of simple tests to find the condition earlier, particularly among people already at high risk.
A major series of papers published in The Lancet describes chronic kidney disease as an urgent and growing global health problem. The work was led by Dr. Jennifer Lees of the University of Glasgow and involved experts from several countries.
Chronic kidney disease, or CKD, means the kidneys have been damaged or are not filtering blood as well as they should over a long period. It is different from a sudden kidney injury, which develops rapidly over hours or days.
Most people have two kidneys, located toward the back of the body below the ribs. Together they continuously filter the blood and remove waste products through urine.
The kidneys also help manage fluid levels, blood pressure, red blood cell production and the balance of minerals needed by muscles, nerves and bones. This is why serious kidney disease can affect much more than urination.
CKD often gives little warning in its early stages. A person may feel completely normal while kidney function is gradually declining.
This silence is one reason diagnosis rates remain low. By the time obvious symptoms develop, the disease may already be advanced and much harder to manage.
Researchers estimate that about 844 million adults around the world have CKD. It is already the ninth-leading cause of death globally and could become the fifth-leading cause by 2040.
Yet a large share of affected people have never been diagnosed. In high-income countries, estimates suggest roughly 30% to 50% of cases may be missed.
The gap can be even wider in some communities. The researchers report that women and some nonwhite groups may be considerably more likely to have undiagnosed kidney disease than white men.
In Singapore, CKD affects about 14.9% of the population. Around six new patients are diagnosed each day, while estimates suggest up to 70% of people with CKD in the community may be unaware of their condition.
These numbers are concerning because early kidney disease can be checked with tests that are already widely available. One is a standard blood test, and the other involves a urine sample.
The blood test measures a waste product and allows doctors to estimate how effectively the kidneys are filtering. The urine test checks for excess protein, which can be a sign that the kidney’s filters are becoming damaged.
Neither test requires a person to wait for symptoms. That makes them particularly useful for people whose medical history already places them at increased risk.
Diabetes is one of the most important risk factors for CKD. High blood sugar over many years can damage the tiny blood vessels and filtering structures inside the kidneys.
High blood pressure is another major cause and can both damage the kidneys and become harder to control when kidney function worsens. Obesity, heart disease, older age and a family history of kidney disease can also raise risk.
Dr. Lees said routine urine testing for protein could create a major opportunity for earlier diagnosis. She particularly highlighted testing people with diabetes, high blood pressure, obesity, cardiovascular disease and a family history of kidney problems.
Early detection matters because modern treatments can slow the disease. Doctors may use medicines that lower blood pressure, protect kidney function or improve the effects of diabetes and heart disease.
Lifestyle measures remain important as well. Depending on the person’s health, this can include stopping smoking, being physically active, eating an appropriate diet and managing body weight, blood sugar and blood pressure.
The aim is not only to prevent dialysis. CKD is closely connected with cardiovascular disease, and people with poor kidney function face a higher risk of heart attack, stroke and other serious complications.
Patients with CKD are also more likely to need hospital care. Once admitted, they have a greater risk of complications and are more likely to be readmitted later.
The new Lancet series examines more than diagnosis. It also looks at differences between men and women, the many causes of kidney disease, new treatment options and ways to make kidney care more personalized.
Clinical Professor Angela Wang of SingHealth Duke-NUS Academic Medical Center and Singapore General Hospital said the rise in kidney disease reflects several trends happening at once. These include more diabetes, high blood pressure and obesity as well as population aging.
Researchers are also exploring newer tools such as genetic testing, advanced biological markers and artificial intelligence. These approaches may eventually help doctors identify exactly why an individual’s kidneys are failing and choose treatment more precisely.
Still, the study series highlights a striking mismatch in modern health care. Scientists are developing highly advanced ways to understand kidney disease while many people who already have it are missing basic blood and urine tests.
The World Health Assembly recognized kidney health as a global priority in 2025. The researchers argue that this recognition now needs to be followed by better screening of high-risk people and wider use of treatments already recommended by medical guidelines.
The papers provide a strong overview of the global problem, but screening policies must consider local populations and health systems. Not every person has the same risk, and the benefits and costs of testing can differ between countries.
The most convincing message is therefore not that everyone needs constant kidney testing. It is that people with clear risk factors should have easier access to simple checks before symptoms and irreversible damage appear.
CKD may remain invisible for years, but it does not have to remain undetected. Finding the disease earlier could allow millions of people to receive treatment while there is still time to protect their kidneys and their wider health.
Source: University of Glasgow.
